2 Executive Summary 1. Personal Independence Payment (PIP) was introduced by the Coalition Government as a major element of the Welfare Reform Act 2012, to be the new benefit for disabled people of working age. It was to be simpler to administer and easier to understand than the working age disability benefit it would eventually replace, Disability Living Allowance (DLA). In this report we assess the extent to which is has achieved its objectives, with evidence drawn from the experiences of people seeking help with the transition from DLA to PIP from us at Citizens Advice Sheffield. 2. We find that there are winners who receive more benefit and losers whose benefit is reduced often substantially. Our evidence indicates that: More restrictive PIP criteria have adversely affected many disabled people with severe walking problems, with older people particularly badly affected. A growing cohort of older people has no opportunity for a review of their benefit if their condition worsens. The assessment process presents specific access problems for Deaf clients and places particular strain on people with mental health issues. There is a question over the quality of DWP decision making, given the high proportion of decisions reversed by the independent appeals Tribunal, and many clients spend months without benefit while going through the appeal process. DWP decisions can be confusing and even contradictory when award letters notify clients of a review date earlier than the end of their award period. Reduced awards under PIP can have a serious knock on impact on RPOHU SMVVSRUPHG NHQHILPV RLPO VXGGHQ MQG VXNVPMQPLMO ORVVHV MQG deterioration in overall quality of life. The PIP process, and subsequent decisions, are far from easy to understand for many clients accustomed to DLA arrangements. 3. The full report below explores these issues in more detail, explaining the LPSM P RI 3 3 GH LVLRQV RQ SHRSOH V OLYHV MQG VHPV RXP POH UMPLRQMOH IRU RXU recommendations, to: Reinstate the benchmark distance of 50m originally proposed by DWP in its public consultation as a gateway to the enhanced rate for
4 The introduction of Personal Independence Payment 4. With the overt aim that 500,000 fewer people would receive the new benefit by 2015 16 than would have received DLA under the existing rules, PIP also promised to deliver savings of over 1 billion a year by 2014 15, rising to 1.5 billion a year by 2016 17.1 The criteria for PIP would be more restrictive and there would be an increase in the numbers of claimants having to undergo a face to face assessment by health care professionals in order to assess entitlement to the benefit. 5. However the envisaged savings have yet to materialise. In early 2016 proposals to restrict PIP criteria further were rejected and led (in part) to the resignation of Iain Duncan Smith as the Secretary of State for Work and Pensions. In his resignation letPHU PR POH 3ULPH 0LQLVPHU OH RURPH have for some time and rather reluctantly come to believe that the latest changes to benefits to the disabled MQG LQ POH RQPH[P LQ ROL O POH\n YH been made are a compromise too far 2 6. In its Welfare Trends report of October 2016 the Office for Budget Responsibility reported POMP POH LQPURGX PLRQ RI 3 3 LV HVPLPMPHG PR OMYH reduced spending by just 0.1 billion in 2015 16, well short of the initial goal of cutting working age spending by 20 per cent relative to DLA 3 PIP in Sheffield 7. In Sheffield, PIP was launched for new claimants in June 2013 and the roll out to existing DLA claimants began at the end of February 2015. There were understood to be 18,000 DLA claimants in Sheffield at the start of the process. The roll out is not expected to be completed until late 2017. 8. The introduction of PIP was rushed. The Department for Work and Pensions (DWP) did not pilot the new process and received widespread criticism of the resulting delays and administrative inefficiencies. The impact on disabled people of the introduction of PIP in Sheffield was 1 Disability Living Allowance reform Commons Library briefing (UK Parliament, February 2011) 2 In full: Iain Duncan Smith resignation letter (BBC News website, March 2016) 3 Welfare Trends Report (OBR, October 2016)
5 detailed in an earlier report by Sheffield Citizens Advice in May 20154. That report described the introduction of PIP, drawing upon the experiences of some of the 1,260 people who contacted us for help with the benefit between October 2013 and October 2014, and mainly focused on the problems caused by delays in the claim and assessment process and the consequent broader difficulties experienced by our clients in Sheffield. 9. DWP and its subcontractors carrying out the medical assessments (ATOS Healthcare in Sheffield) have largely succeeded in reducing these delays and this is welcomed; our recent H[SHULHQ H RQILUPV GJ3 V VPMPLVPL V which show that the time taken for assessments has been greatly reduced. In order to achieve this, however, the subcontractors had to take on additional staff and open more assessment centres, and DWP also introduced new guidance for assessment providers to support them to increase the proportion of cases D V V H V V H G I U R P S D S H U H Y L G H Q F H , an apparent departure from the original intention to increase the numbers of claimants undergoing a face to face assessment under PIP.5 10. Having introduced PIP as the new disability benefit for people of working age, the next, and final, phase of the PIP programme is the reassessment of all DLA claimants under PIP criteria, to make a new decision on continued entitlement to benefit. This reassessment applies to all DLA claimants who were aged under 65 on 8 April 2013, even in cases where their existing DLA award is for an indefinite period. Many of these DLA reassessment claimants have come to us for help. 11. In this report, which follows up our 2015 research, we set out the key issues currently facing PIP claimants and describe the impact on their lives, incorporating individual anonymised case studies which illustrate this in depth. This time we focus mainly on the impact on DLA claimants going through reassessment for PIP. As before, our evidence comes direct from our work with clients, drawing on the experiences of the 2,235 people who contacted us for help with PIP between 1 October 2015 and 31 December 2016. 4 Personal Independence Payment: a report into the impact on the people of Sheffield who approached Citizens Advice for help (Citizens Advice Sheffield, May 2015) 5 Touchbase: DWP news for advisers and intermediaries (October 2014)
6 Differences between DLA and PIP 12. The key differences are: PIP has different qualifying rules to DLA, and the two benefits view disability from different perspectives in that, unlike DLA, PIP is a points based system, meaning that if a claimant cannot show that he or she meets the narrow points based criteria then they cannot get the benefit. The DLA Care component was assessed on the reasonable requirement a claimant may have for either help or supervision from MQRPOHU SHUVRQ HYHQ LI POMP OHOS RU VXSHUYLVLRQ RMVQ P M PXMOO provided). Decisions on the rate of DLA awarded were clearly related to whether the need for help arose either during the day and/or at night. PIP Daily Living component, while not in any way discounting the QHHG IRU M MUHU SOM HV JUHMPHU HPSOMVLV RQ M OMLPMQP V MNLOLP PR carry out certain narrowly specified daily living activities and scores claimants against these. There is consequently less flexibility within the PIP criteria for decision makers to explore the evidence holistically and then make an appropriate award. PIP requires an assessment from DWP V contracted out services before a decision on entitlement can be made. Many DLA claims were decided solely on the information given by the claimant and/or their GP. PIP claimants are more likely to have an assessment involving a face to face consultation, notwithstanding the changes to guidance referred to above. The PIP Daily Living component has two rates of payment whereas the DLA Care component has three. Most PIP awards will be reviewed on a more frequent basis than DLA, even for permanently disabled claimants. However in practical terms the main difference for claimants between DLA and PIP is how entitlement is assessed.
7 PIP roll out in numbers 13. In November 2015 the Office for Budget Responsibility predicted that 74% of transferred claims would result in an award of PIP.6 DWP statistics revealed that, by the end of October 2016, 526,500 DLA reassessments to 3 3 OMG NHHQ OHMUHG LQ *UHMP %ULPMLQB 7 Of these claimants, 75% had received an award, specifically: 209,600 (40%) had their benefit increased; 62,900 (12%) had their benefit left unchanged; and 120,700 (23%) had their benefit decreased, but not stopped altogether. 14. Of the claims which did not receive an award: 110,000 (21%) were disallowed after the assessment; 19,500 (4%) were disallowed before the assessment; and 3,700 (1%) withdrew their claim (mainly where people failed to take up the invitation to claim PIP). 15. In comparison with original forecasts8: 40% of DLA claimants who registered to claim PIP received an increase in the level of benefit, a significantly higher proportion than the 29% forecast in December 2012; 48% of those who registered received a lower level of award or no award, below the 55% forecast in December 2012; and 25% of the cases registered were awarded PIP at the highest rate (enhanced Daily Living with enhanced Mobility components). This compares with 15% under DLA. 16. These figures also confirm that more people with mental heath problems are receiving PIP than under DLA and this is to be welcomed as a positive step towards the Government V VPMPHG MLP RI UHMPLQJ M parity of esteem between physical and mental health problems. However, at the time of writing, this issue is the ongoing subject of debate and parliamentary 6 Economic and Fiscal Outlook (OBR, November 2015) 7 Personal Independence Payment: Official Statistics (DWP, October 2016) 8 Timetable for introducing Personal Independence Payment and estimates of projected caseloads policy briefing note (DWP, December 2012)
8 scrutiny as the Government has introduced amendment regulations to restrict PIP criteria to exclude the impact of overwhelming psychological distress which we consider iV M NM NRMUG VPHS LQ M OLHYLQJ parity of esteem . Impact on our clients Moving the Ralking goalpost 17. Prior to the introduction of PIP, a physically disabled person could show entitlement to the higher rate of the DLA Mobility component if they were assessed as being YLUPXMOO XQMNOH PR RMON under Regulation 12 of the relevant secondary legislation. This assessment took into account four factors: distance, speed, time and manner.9 18. While the DLA legislation did not require a specific distance to be used when determining inability to walk, commonly, when assessing against the other factors, disabled applicants were found to satisfy this test if they struggled to walk up to 50 metres. This approach was generally supported by Upper Tribunals and Courts and became a benchmark for entitlement to the higher rate of the Mobility component. 19. For many disabled people with severe walking difficulties an award of the Mobility component at the higher rate gave access to schemes and concessions designed to improve mobility and independence, including Blue (parking) Badges, travel passes and concessions and reductions in Vehicle Excise Duty. 20. One of the most important of these is the Motability scheme which offers cars, including adapted cars, powered wheelchairs and mobility scooters. Cars supplied through Motability come inclusive of insurance, MOT and breakdown cover thereby reducing stress and worry for users and their families. 21. The benefits of the Motability car scheme to disabled users, their families and the wider economy have been highlighted in independent national research10. This confirms that the s OHPH JUHMPO LQ UHMVHV LPV XVPRPHUV 9 The Social Security (Disability Living Allowance) Regulations 1991 (HMG, December 1991) 10 Economic and social impact of the Motability Car Scheme (Oxford Economics and Plus Four Marker Research, September 2010)
9 independence, enabling them to make spontaneous and independent decisions to travel, and undertake activities of their own choosing. Over 70% of car users surveyed said that they were more independent with a Motability car, with 49% saying a lot more ' L V D E O H G S H R S O H V R Z Q ranking of the choice and control they had over their lives increased, on receipt of a car, from an average of 3.8 to 7.9 (out of a maximum 10). Some 77% of car users surveyed also reported a positive difference to their physical and mental health. 22. Research participMQPV RRQ UMPLQJV RI POHLU MNLOLP PR PUMYHO LQGHSHQGHQPO outside their home increased from an average 3.5 to 8.3 (out of a maximum 10) after getting a car, with increases also in the likelihood of their driving themselves and the frequency with which they did so. There is evidence too that this improved mobility enhances many other aspects of the lives of disabled people and their carers, including their access to health services, education, employment and social activities. For example, of Motability users able to work, 39% said that their car had enabled them to gain or keep employment or get a better job, and the car enabled 7% of carers to improve their employment prospects, in total worth an estimated 1.2 billion in gross wages per year. 23. The research also attempts to quantify the benefits of the Motability scheme to the wider economy, in income and public sector savings. For example, reduced usage of ambulance/dial a ride services by Motability customers was estimated to save the public sector 30m, with a decline in missed medical appointments saving an estimated 32 79 per appointment. Overall, it calculated that in 2009 the Motability scheme contributed an estimated 2,015m to UK GDP (0.1% of the total) and 468m to the Exchequer in tax receipts; also that it supported 21,080 jobs (nearly one in every thousand jobs in the UK). 24. The equivalent PIP criterion is the enhanced rate of the Mobility component which is established if the claimant is awarded 12 points in the moving around assessment. Repeatedly during GJ3 V SXNOL consultation on the introduction of PIP, their proposal set the qualifying threshold at 50 metres, which would have mirrored the equivalent DLA higher rate Mobility criterion. However, when the final Regulations were published the relevant distance had been reduced to 20 metres, thus raising the bar for many claimants with the inevitable consequence for some, including those who condition was unchanged, that they would see
10 a reduced award. For many, this would mean losing access to the Motability scheme. 25. This change in qualifying distance therefore deprives some disabled people and their families of all the benefits highlighted above, causing a sudden, major deterioration in their quality of life. Although there is limited compensation available for some people losing their cars one off payments of either 1,000 or 2,000 depending on when they joined the scheme the amounts involved for individuals are an inadequate substitute, and this funding will sooner or later run out. (The charity Motability received a one off 150 million payment from the Government in 201411 PR GHOLYHU POH RQH off transitional package of support for GLVMNOHG SHRSOH QR ORQJHU HOLJLNOH IRU POH 0RPMNLOLP V OHPH B 26. At the beginning of 2016 it was reported that nearly 14,000 disabled people had had their cars taken away as a consequence of moving from DLA to PIP. 12 Mary is 34 and has Multiple Sclerosis. She has been in receipt of DLA since January 2013. At her last DLA claim renewal in 2015 she was awarded highest rate Care and higher rate Mobility in recognition of the severity of her condition and its effect on her daily living and walking ability, being assessed MV NHLQJ YLUPXMOO XQMNOH PR RMON B 2Q OHU OMLP IRUP VOH GH OMUHG POMP VOH F R X O G Q W Z D O N I X U W K H U W K D Q 50 metres without severe discomfort, and this was verified in writing by a specialist MS nurse. In October 2016 she was invited to claim PIP, by which time her overall condition had deteriorated further so that her walking was limited to 30 40 metres. After assessment she was awarded the standard rate of both Daily Living and Mobility components, scoring 10 points for each. Her mobility score LQ POH PRYLQJ MURXQG M PLYLP RMV NMVHG RQ MQ MVVHVVPHQP POMP VOH RXOG Z D O N P R U H W K D Q P H W U H V E X W Q R P R U H W K D Q P H W U H V Although Mary is considering challenging her award the decision is unlikely to change as it is an accurate reflection of her walking ability, assessed under the 11 Charity Income Spotlight report highlights continued growth in sector (UKFundraising website, May 2016) 12 Nearly 14,000 disabled people have mobility cars taken away (BBC News website, February 2016)